| NPI | 1093872541 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD R. GRASSO President 617-389-4440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: MA 12545) |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2020-08-22 |